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The Effect of a Very-Low-Calorie Diet (VLCD) vs. a Moderate Energy Deficit Diet in Obese Women with Polycystic Ovary Syndrome (PCOS)—A Randomised Controlled Trial

Deshmukh, Harshal; Papageorgiou, Maria; Wells, Liz; Akbar, Shahzad; Strudwick, Thomas; Deshmukh, Ketki; Vitale, Salvatore Giovanni; Rigby, Alan; Vince, Rebecca V.; Reid, Marie; Sathyapalan, Thozhukat


Maria Papageorgiou

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Mrs Liz Wells
Lecturer in Nutrition and Dietetics

Shahzad Akbar

Thomas Strudwick

Ketki Deshmukh

Salvatore Giovanni Vitale

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Professor Marie Reid
Professor of Clinical & Health Psychology/ Consultant Clinical Psychologist


We performed an open-label, randomised controlled trial to compare the effects of a very-low-calorie diet (VLCD) vs. moderate energy deficit approach on body weight, body composition, free androgen index (FAI), and metabolic markers in obese women with polycystic ovary syndrome (PCOS). Forty eligible patients were randomly assigned to a VLCD (n = 21) or a conventional energy deficit approach (n = 19) over the same period. After eight weeks, both groups experienced significant weight loss; however, this was greater in the VLCD arm (−10.9% vs. −3.9%, p < 0.0001). There was also a trend towards a reduction in FAI in the VLCD group compared to the energy deficit group (−32.3% vs. −7.7%, p = 0.07). In the VLCD arm, two women (18%) had a biochemical remission of PCOS (FAI < 4); this was not the case for any of the participants in the energy deficit arm. There was a significant within-group increase in the sex-hormone-binding globulin (p = 0.002) and reductions in fasting blood glucose (p = 0.010) and waist to hip ratio (p = 0.04) in the VLCD arm, but not in the energy deficit arm. The VLCD resulted in significantly greater weight reduction and was accompanied by more pronounced improvements in hyperandrogenaemia, body composition, and several metabolic parameters in obese women with PCOS as compared to the energy deficit approach.


Deshmukh, H., Papageorgiou, M., Wells, L., Akbar, S., Strudwick, T., Deshmukh, K., …Sathyapalan, T. (2023). The Effect of a Very-Low-Calorie Diet (VLCD) vs. a Moderate Energy Deficit Diet in Obese Women with Polycystic Ovary Syndrome (PCOS)—A Randomised Controlled Trial. Nutrients, 15(18), Article 3872.

Journal Article Type Article
Acceptance Date Aug 31, 2023
Online Publication Date Sep 6, 2023
Publication Date Sep 2, 2023
Deposit Date Sep 14, 2023
Publicly Available Date Sep 14, 2023
Journal Nutrients
Print ISSN 2072-6643
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 15
Issue 18
Article Number 3872
Keywords PCOS; VLCD; Metabolic syndrome; Energy deficit diet
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Copyright Statement
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (

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